Heart surgery safe and successful for many 80 year olds

Aug 21 2005

According to a new report, cardiac surgery can be safely performed in octogenarians and may improve their life expectancy.

These findings, by Dr. Samer Nashef, from Papworth Hospital in Cambridge, UK, and colleagues, are the latest to suggest that old age alone, should not be a barrier to cardiac surgery.

Nashef and his team assessed the outcomes of 12,461 consecutive patients who underwent cardiac surgery at a regional center between 1996 and 2003.

Of these subjects, 706 were older than 80 years of age.

The researchers found that compared with their younger peers, the conditions that were more common in octogenarians included impaired function of the ventricle, unstable angina and the need for valve surgery.

The octogenarian group also contained more female patients.

In contrast, the report showed that younger patients appeared more likely to have had previous heart surgery, a previous heart attack and diabetes.

It was found that the hospital mortality rates for all patients and for octogenarians only were 3.9 percent and 9.8 percent, respectively.

Both of these values were significantly lower than what was predicted using a standardized risk stratification system.

The percentage of octogenarians who had an intensive care unit stay longer than 24 hours was 37 percent, which was significantly higher than the 23 percent observed for younger patients.

Perhaps most surprisingly the 5-year survival rate for surgery-treated octogenarians was 82.1 percent, while the rate for their age- and sex-matched peers in the general population was 55.9 percent.

In conclusion the researchers comment that this study is the largest UK single-center experience, and the largest risk-stratified, comparative study in the world, which has examined long-term outcomes of cardiac surgery in the elderly.

They say it confirms that cardiac surgery in selected octogenarians can be performed with good results.

The report can be seen in the online issue of the medical journal Heart.